Deformation of the cervix

Deformation of the cervix is a violation of the normal structure of the cervical canal and structures of the cervix, which is of clinical importance. This pathology is not so common, and even less often it has symptoms that arise only under certain conditions, that is, become clinically significant. The reasons for the development of this pathology can be many, and the correction of this pathology is very problematic, so you should be careful about your health and prevent any complications.

[1], [2], [3], [4],

Causes of the cervical deformities

Deformation of the cervix can develop after certain conditions, and can also be a congenital pathology. It often happens that the development of the female reproductive system is disrupted at a certain point, and various anomalies in the structure of the female organs, including the cervix, develop. Congenital anomalies, as a rule, are accompanied by concomitant anomalies of other genital organs - the vagina, the uterus. More often in women of reproductive age, there are acquired anomalies in the structure of the cervical canal, which results from adhesions, scarring, deformities after various surgical interventions. Cervical deformities include conditions that are accompanied by a breakdown in the structure and integrity of the cervix and cervical canal - a circular channel of the cervix, a narrowing of the cervical canal and its obstruction, an elongated cervix, a cervical shortening or an ischemic-cervical insufficiency, cicatricial and post-traumatic deformations cervix.

Circular canal of the cervix is a pathology in which the canal has a funnel-like shape due to the misposition of the muscle fibers in the circular direction. This pathology can occur with ruptures of internal genital organs due to childbirth and their surgical treatment - suturing, in the future this can be the reason for this process with improper tissue healing. At the same time, the anatomical location of the muscular fibers of the cervix is broken, and it can no longer contract, as before, which further promotes the manifestation of a particular clinical picture.

The narrowing of the cervical canal is less than 5 millimeters in size. Moreover, women of reproductive age may already have symptoms, in the form of a disorder of the menstrual cycle as oligomenorrhoea, since a narrow channel of the cervix can interfere with normal menstruation, which prolongs the period of menstruation with a small amount of secretions. With regard to pregnancy, this can be a direct threat to normal labor, in case of poor opening of the cervix and indication for cesarean section. The extreme degree of narrowing of the cervical canal is its obstruction. Obstruction of the cervical canal of the cervix is when a mechanical obstruction in the cervical canal is formed, which may be the cause of further deformities.

The elongated cervix is a pathology in which the length of the cervix is more than 45 millimeters, and often it is accompanied by a change in the consistency of the uterus and the thickness of the uterine throat.

Shortening of the cervix or ischemia-cervical insufficiency is a condition in which the length of the cervix is less than 35 millimeters, which is often 20-25, which is a risk of miscarriage in the future and requires correction.

Cicatricial and posttraumatic deformities of the cervix are the most frequent cause of the development of various pathologies in the future. The cause most often becomes trauma to the genitals after childbirth, ruptures of the cervix, damage to the wrong positions of the fetus, improperly applied sutures or the effects of their scarring, violations of the technique of surgical interventions on the cervix uterus.

All these reasons can disrupt the normal physiological structure of the cervix, and in response to such foreign bodies, regeneration and proliferation of connective tissue develops, and later scar tissue develops, which contributes to deformation of the tissue.

[5], [6], [7], [8]

Symptoms of the cervical deformities

The peculiarities of the clinical course of various cervical deformations are that the symptomatology is often not expressed until the appearance of complications and the course is asymptomatic. When there are certain problems with pregnancy, childbirth or the course of some diseases, then only this pathology can be found. But there are special features in the clinic of some strains of the cervix.

The circular channel of the cervix is a deformation that can not be manifested in any way because of its insignificance, that is, all the physiological processes in the uterus and ovaries do not suffer. Problems can arise in the next pregnancy, when there can be discoordination of labor activity due to an abnormal reduction in the muscle fibers of the cervical canal, which prevents the normal opening of the cervix.

With narrowing of the cervical canal, the first signs of this pathology can manifest as a violation of the ovario-menstrual cycle because of the appearance of a mechanical obstruction in the path of normal menstrual function of the endometrium. But such changes may not be frequent, and narrowing of the canal can have an asymptomatic course. In the case where the uterine deformation, in this situation, constriction, reaches an extreme degree, then the impaction of the cervix develops - this is a condition that can already have pronounced clinical manifestations. Symptoms of this type of deformity can be the formation of a mechanical obstruction, which in women of reproductive age can cause a delay in menstrual blood with its accumulation in the uterine cavity and the formation of acute conditions in the gynecology - the hematometer. Then there is a clinic of acute abdominal pain, anterior abdominal wall tension, and anamnesis indicates a delay in menstruation for several weeks or several times in a row.

The elongated cervix is a pathology that also often occurs asymptomatically. Sometimes in previously unfertilized women, the first signs of the disease may be dyspareunia - a violation of the normal process of sexual intercourse, in which the woman does not enjoy and reduces sexual desire. This is due to the fact that the elongated cervix does not have a sufficient number of receptors and blood supply can badly occur, which violates normal sexual intercourse. There are no painful sensations, since the internal structure has not been changed and there are no obstacles. Often a symptom of this kind of deformity can be infertility, since there are problems with conception because the sperm can not reach the uterine tube for a normal fertilization process. Also in the elongated cervical canal a dense mucous plug can be formed, which has an acidic environment, which also prevents the passage of the sperm.

Symptoms of the long cervix can manifest for the first time during pregnancy or even during childbirth. In pregnancy, normal attachment of the placenta may be impaired, since the anatomical structure of the uterine throat is disturbed and the placenta may have a central, lateral or low attachment. There may also be problems in childbirth - there are obstacles to the normal passage of the child through the birth canal, since the elongated cervix is not dilated enough and the baby's head or the presenting part may be in the same plane for a long time, which increases the risk of hypoxia and may need additional methods - obstetrical forceps . This can further injure the birth canal and lead to secondary deformations of the cervix.

Shortening of the cervix, as a type of deformation, has clinical symptoms during pregnancy, since there is a threat of abortion. This is due to the fact that the normal length of the cervix throughout the pregnancy should be at least 35 millimeters, then at 34-36 weeks, the length of the cervix decreases as it prepares for childbirth, and at the same time its length is approximately 34-36 millimeters, but it can be 30 and this is considered a normative indicator. In case of inconsistency of these indicators, there may be pathological birth or complications in childbirth in the form of premature passage of amniotic fluid, umbilical cord entanglement, therefore this kind of deformation requires timely diagnosis and treatment.

Cicatricial and posttraumatic deformations of the cervix very often do not manifest themselves, but they require increased attention in women of reproductive age. These deformations occur after traumatic births, and the symptoms may appear even during the next pregnancy. In this case, the normal contraction and opening of the cervix will be disturbed, which may contribute to prolonged labor or because of marked cicatricial changes may become an indicator for cesarean section. The first signs of such deformations can be painful sensations during intercourse, which can be caused by scarring of the cervix, which disrupt the normal contraction during excitation and disrupt the outflow of blood from the veins of the pelvis. Secondary can develop stagnant phenomena in the small pelvis with further inflammatory or other diseases of the female reproductive system.

Cicatricial deformity of the cervix is most often encountered in large fetuses or in abnormal fetal positions. Deformation of the cervix after childbirth can also have an asymptomatic course, so it is necessary to carefully examine the birth canal and properly guide the postpartum period.

[9], [10], [11]

Complications and consequences

Considering the fact that cervical deformity has asymptomatic in most cases, very often these conditions are diagnosed already when complications appear. Such complications can appear already during childbirth, then it is very dangerous. Fetal hypoxia can occur if there is a violation of its passage through the birth canal, as well as birth injuries, cephalohematemata and other abnormalities from the fetus.

[12], [13]

Diagnostics of the cervical deformities

The asymptomatic course of different types of cervical deformities complicates timely diagnosis. Complaints in such patients are absent, and when examined, no particular changes are detected.

But nevertheless it is necessary to examine the woman carefully even during routine examination. When examining women with such deformations, there are no special changes: in a bimanual vaginal examination, no complaints or symptoms are detected. Inspection in the mirrors is also poorly informative, because only the neck itself is visible, but if the scar deformations are very pronounced, changes can be seen. Then it is not difficult to suspect a diagnosis. It is necessary to carefully collect a common anamnesis and obstetric anamnesis with details of the number of deliveries, their course, consequences, because it will help to find out if this woman has risk factors.

Analyzes do not allow to suspect this pathology, as general clinical laboratory tests - the general analysis of a blood, urine - in norm. The absence of changes in the general analysis of blood can only exclude inflammatory diseases. Special laboratory studies - the smear of the cervical canal on the flora and on the dysplasia - also remained unchanged in the absence of concomitant pathology.

Instrumental diagnostics is the "gold standard" in diagnosing various types of deformation, as it allows visualizing any changes.

Changes in the size of the cervical canal can be diagnosed by ultrasound. To do this, use a special method - cervicometry - this method consists in ultrasound examination of the cervix with measurement of its dimensions. Thus, it becomes possible to measure the length of the cervix, its width and the size of the uterine throat, which allows one to judge the pathology of lengthening and shortening of the cervix. Ultrasound can also detect cicatricial cicatricial deformities if they are significant, since the heterogeneous structure of the cervix is visualized.

[14], [15]

Differential diagnosis

Differential diagnosis of various deformations should be carried out primarily with various functional impairments during childbirth. Since the first signs of deformation of the cervix can arise during childbirth, it is necessary to clearly differentiate the secondary weakness of labor with anatomical disorders of the cervix in the form of its deformation. With the weakness of labor, the cervix opens, but its dynamics are not sufficient for normal delivery. With deformities of the cervix, it can not open and its uneven structure is visualized.

It is also necessary to conduct differential diagnosis of cervical deformity, which occurs when infertility. Then you can exclude many inflammatory factors, and the cause of infertility can be different. To do this, it is necessary to carefully examine a woman with mandatory hysterography, which allows to detect defects not only of the cervix, but also of the uterine cavity.

Treatment of the cervical deformities

Treatment of cervical deformity between childbirth or in women of unproductive age is not required, since this condition is not dangerous. In the case of infertility, preparation for pregnancy or during pregnancy, it is necessary to take measures, since complications can arise.

Treatment of cervical deformity before delivery can be conservative and operative. It includes the complex action of massage to improve the outflow of blood and lymph, physical exercises to strengthen the pelvic muscles and perineum as a coordinated action of these muscles in childbirth, as well as medical methods.

Since deformations involve anatomical abnormalities, medication can be ineffective in the radical correction of this pathology, perhaps only symptomatic therapy in certain conditions that are caused by cervical deformities. For example, if the normal opening of the uterine pharynx due to the long cervix or deformity is disturbed, stimulation of labor is carried out. This can be done using mechanical methods - Foley's catheter or with the help of amniotomy or manual detachment of the placenta on a short distance. It is also possible to stimulate labor by applying laminaria. Laminaria - seaweed, from which special sticks are made, which in the vagina increase in size 5-6 times and stimulate the opening and smoothing of the cervix. Prostaglandins E 2 - misoprostol are also widely used. This drug, called "Mirolut" is released in the form of tablets of 4 tablets in a pack at a dose of 200 μg of active ingredient, and is used rectally at once 4 tablets. This method of stimulation of labor with the long cervix is widely used, since it is affordable and effective. You can use prostaglandins in the form of vaginal suppositories or ointments. Such methods of stimulation are possible only in the absence of scars on the uterus, that is, when the previous delivery was carried out naturally.

Operative methods of treatment are of high priority in case of significant deformations of the cervix, as it is possible to correct such deformations. They use different methods of surgical treatment, which depends on the type of pathology. Often, minimally invasive interventions for certain indications are made, as they are less traumatic, especially if pregnancy is also planned. In case of violations of the structure of the cervix due to deformities, such as constriction or obstruction of the cervical canal, a special procedure is performed - bougiezing of the cervical canal. This intervention, which consists in expanding the channel with a special tool - buzhom. This is most often a metal tool that is matched to a number that corresponds to its size, and starts from the smallest to the widest. It is often necessary to repeat the procedure several times, because one time is not enough. Such intervention is effective at small degrees of constriction.

In the case of more severe deformities and huge cicatricial changes, cervical uteri perform open surgical interventions with further plastic surgery of the cervix. Can carry out a small excision of the deformed part of the cervix and then suture such amputations with the expansion of the cervix. The choice of the method of surgical treatment is carried out individually, taking into account the degree of deformation, age and purpose of treatment.

Alternative treatment of cervical deformities

Alternative methods of treating cervical deformities are prevalent, as they are not harmful in the planning of pregnancy and can reveal a pronounced effect in certain cases. They use both herbal treatments and alternative methods. In case the deformities of the cervix hamper the normal opening of the cervix uteri already at the time of delivery, then methods that help to relax the slightly deformed tissues of the cervix uteri.

The main methods used in this process are:

• Sea buckthorn oil also has an anti-inflammatory effect. Sea-buckthorn oil, which can be purchased at a pharmacy, dips a tampon and injected into the vagina for 2 hours, which is best done before bedtime. The course is at least ten procedures.
• Treatment with honey - one tablespoon of honey should be diluted in liter of boiled water and douching twice a day. This course must be completed within 7-10 days. Honey has a pronounced relaxing effect on the uterine myometrium, and it also has a bacteriostatic and immunomodulating effect.
• Use celandine - a tablespoon of dried celandine leaves should be poured a glass of boiled water and boil for another five minutes, then let cool and strain. This broth should be drunk half a cup three times a day for about a week.
• Acacia shows a good effect in the treatment of cervical deformities. To make the tincture, you need to collect the acacia flowers, dry them, pour alcohol and insist in a dark place for at least a day, and after that dilute with boiled water take one tablespoon three times a day. The course of treatment lasts one month.
• Juice of a burdock perfectly removes irritation, edema and has a healing and spasmolytic effect, which enhances the regeneration of the myometrium and improves its ability to relax. To make a healing solution from the burdock leaves pre-washed, you need to squeeze out the juice and take five days for one teaspoon three times a day, and then one teaspoon twice a day for five more days.

Herbal preparations are also widely used in the treatment of cervical deformities, as they contribute to normal nervous regulation of the processes of contraction and relaxation of the cervix.

Basic recipes using herbs:

• Recommend a soothing and firming tea-decoction of herbs, which has a hysterotropic effect. For this, leaves of raspberries, strawberries and hawthorn insist in boiled water and boil for five to ten minutes, after which they drink tea instead of tea up to four times a day.
• Plantain leaf, horsetail, nettle leaves and lemon balm, dandelion root should be poured with one liter of water and boil. After this, you need to insist a decoction 3-4 hours and take in the morning before eating a teaspoon.
• Grass of oregano, birch buds, St. John's wort, calendula, chamomile, celandine, linden and turn are poured with boiling water, insist and drink half a glass 4 times a day.
• Cones of hops, valerian, lime, coriander, motherwort and oregano must be filled with a liter of hot water and after being infused, drink in the morning and in the evening 2 teaspoons.
• inflorescences and blackberry fruits, you can also use blueberries, pour boiling water and insist, add honey for taste and drink on a teaspoon three times a day.

The use of homeopathic remedies can be effective if the cervical deformities are combined with other hormonal disorders. To treat this pathology also use homeopathic remedies. Their main effect is aimed at regulating the normal hormonal background and this contributes to the normalization and tone of the cervix, especially when it is deformed.

The most famous homeopathic preparation that has an effective effect is Kaulofillum - an extract of a plant that is released in the form of homeopathic granules. During pregnancy, two weeks before childbirth, it is used for prophylactic purposes when the cervix is deformed in the form of 3 pellets two times a day. Already during labor with discoordination or weakness of labor, the drug is used 3 capsules every half hour.

Another drug used in this case is Pulsatilla. In addition to pronounced myotropic action, it also has a relaxing and analgesic effect. Such an effect contributes to the normalization of the tone of the uterus and the normal dynamics of the opening of the cervix in the case of its scar changes. The drug is produced in homeopathic granules and is used in the same dosage and according to the same principle.

Arnica - has the same effect, but apart from the analgesic and hysterotrophic action, its additional function is revealed - this is the prevention of postpartum bleeding. This prevents secondary traumatic injuries.

These are the main methods of treating this pathology, both folk and phytopreparations and their timely use makes it possible to avoid complications.

[16], [17], [18]

Prevention

With regard to the prevention of this disease, then there are only nonspecific methods. This includes:

• hygiene of sexual life with the prevention of genital infections;
• timely treatment of inflammatory and non-inflammatory diseases of female genital organs;
• annual preventive examination at the gynecologist;
• pregnancy planning with mandatory comprehensive examination of a woman;
• correct delivery tactics and timely qualified obstetric care in childbirth.

These are the main preventive measures not only for this disease, but for a group of others that are dangerous for women and which can be prevented even before their development.

[19], [20], [21], [22], [23], [24]

Forecast

The prognosis of cervical deformities for life is favorable, since there is no pronounced clinical symptomatology that threatens life. For a complete recovery, the prognosis is also favorable, because today there are a lot of different methods of surgical treatment, after which the deformations are completely corrected.

Deformation of the cervix is a pathology that occurs in every fifth woman who has had traumatic births. This pathology does not bring discomfort until the moment when another pregnancy occurs, when complications may arise. Therefore, it is important that there is a timely and correct tactic of conducting births from doctors, as well as compliance with all nonspecific rules of prevention by women.

[25], [26], [27]